| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | KAISER FOUNDATION HEALTH PLAN INC | $48K | $0 | $48K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $3K | $12K | 13.50% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $2K | $5K | 5.58% |
| MYKISHA L. THOMAS3 | 3886 3RD AVENUE LOS ANGELES, CA 90008 | AFLAC | $3K | $364 | $3K | 10.05% |
| BETTINA ROSE REMPE3 | 10821 WOODBINE STREET LOS ANGELES, CA 90034 | AFLAC | $634 | $24 | $658 | 2.13% |
| MJ INSURANCE3 Filed as: MARTHA F. GARCIA AND VARIOUS AGENTS | 4067 HARDWICK STREET, SUITE 289 LAKEWOOD, CA 90712 | AFLAC | $449 | $14 | $463 | 1.50% |
| TALHA ZAQUIR RAHMAN3 | 10973 PRESCOTT DRIVE FRISCO, TX 75033 | AFLAC | $298 | $65 | $363 | 1.18% |
| DAVID HERNANDEZ3 | 2239 WEST 190TH STREET TORRANCE, CA 90504 | AFLAC | $344 | $0 | $344 | 1.11% |
| STEVEN R. JOHNSON3 | 2239 WEST 190TH STREET TORRANCE, CA 90504 | AFLAC | $105 | $0 | $105 | 0.34% |
| MJ INSURANCE3 Filed as: JARON PATRICK HAMLETT | 900 WEST OLYMPIC BOULEVARD UNIT 38D LOS ANGELES, CA 90015 | AFLAC | $55 | $0 | $55 | 0.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA COMPANY | $675 | $187 | $862 | 12.98% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 265 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 265 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 145 | $959K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 187 | $89K |
| Vision | VISION SERVICE PLAN | 145 | $0 |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 265 | $89K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 265 | $120K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 265 | $89K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 145 | $959K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 265 | $120K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 265 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.